Tuesday, May 12, 2015

Homeopathy and the UK’s National Health Service

Homeopathy is arguably the silliest form of alternative medicine: the published studies show no evidence of anything beyond nonspecific contextual effects, and the underlying premise is incompatible with the existing body of scientific knowledge. Homeopathy has increasingly been questioned or denounced by organizations in several countries, most recently in FDA hearings in the US.

I recently spoke at the QED conference (Question, Explore, Discover) in Manchester, England. Another speaker, Michael Marshall, gave a talk on homeopathy and the National Health Service. He presented information that was new to me and that I thought was worthy of sharing with SBM readers.

Background

Homeopathy is more widely accepted in Europe than in the US. In Britain, homeopathic hospitals persisted long after the last one closed in the US, and the National Health Service (NHS) still provides homeopathy. Queen Elizabeth travels with a kit of homeopathic remedies, and Prince Charles is so infamous for his support of homeopathy and all things alternative that Simon Singh and Edzard Ernst ironically dedicated their book Trick or Treatment: The Undeniable Facts About Alternative Medicine “To HRH The Prince of Wales.”

I thought homeopathy was funded by the National Health Service. I was right. I thought that meant anyone in the UK could get it for free. I was wrong.

Funding decisions are local. They are made by 211 Clinical Commissioning Groups (CCGs). There is no central accounting of how much the NHS spends on homeopathy. The only way to get information is to send FOIAs to every CCG individually, and that is exactly what the indefatigable Michael Marshall did.

The results:

174 CCGs said they did not fund homeopathy

6 CCGs were unsure if they funded homeopathy

14 CCGs said they funded homeopathy

17 couldn’t tell him whether it was funded

On a map, the areas funding homeopathy look strikingly sparse. It is funded in Newcastle, Liverpool, and Bristol; and London “could not say” whether it was funded.

How much is spent?

There are four CCGs in the Newcastle area, spending from £3.27 to £176.56 annually, for a total of £231.39. Total spending in Bristol is £242,303.

There are 17 CCGs in London that don’t know how much they spend on homeopathy. Marshall’s best guess, extrapolating from data from a single FOIA, is that it is probably well over £3,000,000.

In the Liverpool area, the 5 CCGs’ spending ranged from £18.68 to £34,050.

The total reported expenses for England were £2,004,012; but that doesn’t include London, so the actual figure may well be over £5 million, which seems quite a lot to spend on sugar and water.

In Glasgow, 355 patients were treated in Scotland’s only homeopathic hospital annually at a cost of £3605 per patient for remedies. Remedies are supplied by Freeman’s Homeopathic Pharmacy, whose website lists 3400 different remedies:

489 from animals, including badger, buzzard and 7 types of butterfly

111 from humans, including dandruff, semen, and breast cancer aspirate

6 from colors, including blue, orange, rainbow, and full color spectrum

Freeman’s told Marshall that homeopathic owl couldn’t be sold without a prescription, but he easily obtained some by buying it online.

Liverpool reconsiders

In 2014, the homeopathy-funding contract expired for the Liverpool CCG and they had to decide whether to renew funding. Consultation (with input from skeptical groups) recommended ceasing funding, and there was no public support, but they decided to fund it anyway! Their decision was challenged through Judicial Review, and the contract is currently on hold until after the election.

Homeopathy in decline

Demand for homeopathy is declining in the UK. The number of prescriptions is down 94% from a high of 170,000 in 1996, and prescription costs have dropped by almost 90%.

Activism

Michael Marshall is a project director for the Good Thinking Society, an organization founded by Simon Singh for science advocacy, consumer protection, direct activism, media watchdog, and community support. They have addressed a wide variety of issues such as live blood analysis, astrology, dental amalgams, chiropractic, and cancer quackery. Their annual Golden Duck award is given to the person or organization that has supported or practiced pseudoscience in the most ludicrous, dangerous, irrational or irresponsible manner. In 2012 they gave a Golden Duck Lifetime Achievement Award to Andrew Wakefield. If you want to help their efforts, you can donate via their website and PayPal.

Marshall is vice president of the Merseyside Skeptics Society, which organized the 10:23 campaign (a reference to Avogadro’s number, which shows that no active ingredient is left in highly dilute remedies). 10:23 raises awareness of the inefficacy of homeopathy by holding public demonstrations where participants overdose on homeopathic remedies, taking 20 times the recommended dose of arsenicum album. By 2011 the demonstrations had spread to involve 1700 people in 70 cities in 32 countries and seven continents (even Antarctica!).

An anecdote and a thank-you to the NHS

Within two hours of my arrival in Manchester for the QED conference, I had an accident. I missed a step and my face impacted the pavement, resulting in profuse bleeding, two broken upper front teeth, a bad lip laceration with embedded tooth fragments, and a chin laceration. Passers-by stopped to help and called an ambulance. I was transported to the university hospital, given pain pills, x-rayed, treated and sutured by a maxillofacial surgeon. It didn’t cost a cent, and I wasn’t even asked for ID. I was very impressed by the quality of care and by the caring attitude of the providers, and I couldn’t help but think how different an injured foreigner’s experience would have been in the US. Thank you, NHS! You do so many things so well; it is a shame you haven’t been able to completely eliminate funding for homeopathy.

Conclusion

Funding for homeopathy exists only in isolated pockets in the UK, and support for it continues to decline. In my opinion, government-supported health care should be for effective medicine; there is no reason for the government to spend taxpayer money on placebo medicine. “Health freedom” advocates still have access to homeopathy and they can pay for it themselves.

Note: Many thanks to Michael Marshall for sharing his PowerPoint slides with me and for all the good work he is doing to promote science and reason.

A personal note: In case anyone is worried about me, I am OK. My daughter was travelling with me, which was a big help. My facial bruising and scabs made it look from a distance like I was growing a beard, but it didn’t interfere with my giving my talk and participating in 2 panels at QED. I went on to speak at Skeptics in the Pub in York and Liverpool. Then we went to Reykjavik, Iceland, where I spoke to a humanist group. We got to do a lot of sightseeing, including the one and only Penis Museum in Reykjavik. Now back home, I’m getting two root canals and my dentist thinks he can save my teeth and restore them to a semblance of normality.